"Virginia Tech," the analyst replied grimly. "It's been a few weeks, now the media pack is chasing the latest sex scandal and the early maneuvering in the presidential campaign. Once again, just like after Columbine, we hear all kinds of proposals, mostly wrong, and then dead silence. So it happens again, and again and again. And I have this verse, I think it's from one of the prophets, that I can't get out of my head: 'A voice is heard in Ramah, lamentation and bitter weeping. Rachel is weeping for her children, refusing to be comforted, because they are gone.' "

"Did you have someone there?" the analyst's friend inquired.

"No," the analyst said. "My daughter's friends were OK, although a couple of their friends weren't. But that's not the point. This could have happened, and could happen again, anywhere, any time. I really feel for the families, especially the parents of that kid who did the shooting. It must be terribly hard on them. At least the other families are getting sympathy. I don't even want to imagine the hate messages that kid's family must be getting."

The friend could manage little more than a surprised expression.

"What bothers me most," the analyst went on, "is that all this was preventable, and we O.R. analysts should know that better than just about anyone else. That kid apparently had mental illness problems for years, lots of people tried to get him to get help, there was even a court hearing where the judge ruled him dangerous — that's usually the hurdle these cases never clear. But then the judge was persuaded to order outpatient treatment instead of inpatient commitment, and under Virginia's practices, nobody was responsible for making sure he stayed with the treatment. That's fairly typical, by the way. They had an online system to check gun buyers for histories of violence or indications that they were dangerous, too, but it seems whoever was responsible for sending the information to the system thought it wasn't required if the kid wasn't hospitalized. The gun store owner checked and the kid came up clean.

"I hate to sound like a bleeding-heart liberal," the analyst continued, "but this is one situation where most of the blame really is on society, not the perpetrator."

A grim pause followed.

Finally, his friend broke the silence: "So why do you say our profession should know better than others what to do?"

"We're the systems thinkers," the analyst explained, "and this is a systems problem. Clearly there was just no established hand-off of responsibility from one institution to another. The police did their job and brought the guy in for evaluation. The state's psychiatrist did his job and made a clear case that the guy was dangerous. The court did its job, reached the right finding and ordered treatment. But then there was nothing in the system to ensure that anything happened next!

"I wrote an article for OR/MS Today a few years ago," the analyst said, "where I quoted E. Fuller Torrey, one of the country's leading experts on serious mental illness. Talking about the way this country emptied out the inpatient hospitals and then implemented this haphazard, unverified, unmanaged patchwork of so-called community care, he wrote, 'If I had asked my most disorganized schizophrenic patient to design this process, he couldn't have come up with anything worse than what we have.' And we've known this for years before that. But I can't even get most of my colleagues in the profession to take the subject seriously when I talk about it, much less to get involved in trying to do something."

"This was known after Columbine?" his friend asked.

"This was known after John Hinckley shot Reagan, in 1981," the analyst replied. "His parents had been trying for two or three years to get someone to help force him into treatment, but no one would act until he actually did some harm. And then the only reason he wasn't back out on the streets, still unmonitored, 15 years ago is that he shot the president, so the Secret Service can — and does! — object to releasing him. Think about it! All these billions of dollars we spend on allegedly improving homeland security, and we ignore this real, largely preventable threat. In that article I mentioned, I led with the claim that mental illness is a major national security issue. How many people, even in our supposedly knowledgeable profession, have even gotten far enough to understand why that's so?

"I try to tell people that this will keep happening until we figure out how to deal with it," the analyst concluded, "and they don't want to think about it. They say it's depressing. Sometimes they act as if maybe I'm crazy. I have to admit, to see this kind of thing happening over and over, to feel for the families, to know we could stop it, and to have no one paying attention, might just make a person crazy. What is it going to take?"

His friend nodded sympathetically — and, without realizing it, edged away a bit. The analyst laughed, pointed to where his friend was now sitting and said, "See?"



Doug Samuelson (samuelsondoug@yahoo.com) is a senior analyst at the Homeland Security Institute in Arlington, Va.

Note: The article was "Can OR Help Stop 'The Invisible Plague?'", June 2004. The Scriptural quote is Jeremiah 31:15.

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